Imaging Coccygeal Trauma and Coccydynia

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:

Computed Tomography: 1.75
Procedures: 1.75
Head, Spine, and Musculoskeletal: 1.75

Magnetic Resonance Imaging: 1.75
Procedures: 1.75
Neurological: 1.75

Radiography: 1.75
Procedures: 1.75
Head, Spine and Pelvis Procedures: 1.75

Registered Radiologist Assistant: 1.75
Procedures: 1.75
Neurological, Vascular, and Lymphatic Sections: 1.75

Outline

1. Introduction
2. Anatomy
   1. Osteology
   2. Attachments
   3. Neurologic Structures
3. Idiopathic and Traumatic Coccydynia
   1. Dynamic Imaging
   2. MR Imaging
   3. Treatment
4. Other Causes of Coccydynia
   1. Neoplasm
   2. Infection
   3. Cycts
   4. Crystal Deposition
   5. Referred and Neurogenic
5. Conclusion

Objectives

Upon completion of this course, students will:

1. be familiar with the anatomy of the coccyx
2. be familiar with the curvature Types of the coccyx
3. be familiar with curvature Types most common in females
4. identify the curvature Type most frequently associate with coccydynia
5. be familiar with the attachments of the coccyx and sacrococcygeal region
6. be familiar with Waldeyer fascia
7. be familiar with the anocococcygeal ligament
8. be familiar with the ganglion impar and its function
9. identify the modality recommended to diagnose an acute fracture of the coccyx
10. recognize the different categories of idiopathic and traumatic coccydynia
11. be familiar with the predominance of coccydynia based on gender
12. be familiar with the patterns of hypermobility associated with coccydynia
13. recognize the degree of motion associated with rigid coccyx
14. be familiar with the patient positioning when performing dynamic imaging
15. be familiar with the MRI techniques used to evaluate coccydynia
16. be familiar with the histological changes of those undergoing coccygectomies
17. understand the effectiveness of conservative treatment of coccydynia
18. be familiar with those that would perform manual therapy to treat coccydynia
19. identify the targets for steroid or anesthetic injection for treatment of coccydynia
20. be familiar with the effectiveness of CT-guided ganglion impar blocks for treating coccydynia
21. identify the greatest risk factor for those undergoing a coccygectomy
22. recognize how a chordoma appears in medical imaging
23. recognize the appearance of a chordoma on MR imaging
24. be familiar with the occurrence of pilonidal cysts and sinuses
25. be familiar with the patient profile for those presenting with pilonidal cysts
26. be familiar with the findings of calcium deposition in sacrococcygeal or intercoccygeal joints
27. identify the calcium crystals that have been found in the discs of the spine
28. be familiar with the MR imaging sequence utilized to demonstrate a pilonidal cyst
29. be familiar with the imaging modality used to image focal calcifications in the coccygeal body
30. be familiar with the role of CT and MRI in the work-up of a patient with coccydynia